Individual provider Active NPI

Samantha Thea Carbonaro, RN, MSN PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Pembroke Pines, FL
National Provider Identifier
1245183755
Registry record updated Feb 16, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
2025097351 Issued in FL
Practice address
1070 SW 85TH Ave
Pembroke Pines, FL 33025-5304
Phone
(954) 707-3052
NPI assigned
Feb 16, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 16, 2026

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2025097351 FL Primary

Addresses

Primary practice location

1070 SW 85TH Ave
Pembroke Pines, FL 33025-5304

Mailing address

1070 SW 85TH Ave
Pembroke Pines, FL 33025-5304
Phone (954) 707-3052

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
2025097351FLMDPsychiatric/Mental Health Nurse Practitioner

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1771200000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1771200000000",
    "number": "1245183755",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1070 SW 85TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255304",
            "telephone_number": "954-707-3052"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1070 SW 85TH AVE",
            "city": "PEMBROKE PINES",
            "state": "FL",
            "postal_code": "330255304",
            "telephone_number": "954-707-3052"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARBONARO",
        "first_name": "SAMANTHA",
        "middle_name": "THEA",
        "name_prefix": "Ms.",
        "credential": "RN, MSN PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-02-16",
        "last_updated": "2026-02-16",
        "certification_date": "2026-02-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "FL",
            "license": "2025097351",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pembroke Pines, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 16, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.